Casos de síndrome de Guillain-Barré internados e/ou notificados em Cuiabá-MT, 2014-2018

Abstract

After polio eradication, Guillain-Barré syndrome (GBS) has become the leading cause of acute flaccid paralysis worldwide. With the Zika virus (ZIKV) epidemic in Brazil in 2015, the Ministry of Health received reports from all Brazilian states indicating an increase in reporting of GBS cases. With the occurrence of the ZIKV epidemic in Cuiabá, this study investigated cases of GBS that occurred in this period. Objective: To report cases of Guillain-Barré Syndrome hospitalized and/or notified in Cuiabá-MT, 2014-2018. Method: Study of a series of GBS cases using data from medical records and supplemented by telephone interviews of cases admitted and/or notified to the Municipal Health Department, in Cuiabá-MT from November 2014 to March 2018. Results: During the study period, 35 cases of GBS were found and 15 were interviewed, with a growing number of cases (R2

=0.89). The majority were male (60%), race/color brown (71.9%), mean age 37.4 years (1 to 80 years); had completed high school or more (66.7%); received treatment with intravenous immunoglobulin (89.3%) and all of them progressed to discharge. The median length of hospital stay was 8 days (from 3 to 107 days). The Guillain-Barré Syndrome Protocol of the Ministry of Health of 2015 was used, and all cases filled in the essential clinical criteria and at least 3/7 suggestive clinical criteria. The liquor was compatible with the diagnosis of GBS, with protein increase (n=29/32, median=124 mg/dL) and number of normal cells (n=30/30, median=2 cells/mm3). In the sera, 57.1% (n=8/14) for ZIKV IgG (ELISA) and 42.8% (n=6/14) negative were positive. Of the liquors tested for ZIKV IgG (ELISA), 10% (n=1/10) were positive and 90% (9/10) were negative. In the technique by RT-PCR all the tested samples were negative for the four arboviruses, Zika, dengue, Chikungunya and yellow fever. Conclusion: It is possible that the increase in the number of GBS cases during the study period is related to previous infection with the Zika virus, considering that 25.7% of the cases were ZIKV IgG positive in samples of samples collected during the and 2.9% of the cases were positive ZIKV IgG in sample collected after discharge. The negative ZIKV IgG test removed the possibility of previous infection by ZIKV in 22.9%. The personal testimonies of the interviewed cases indicate that after discharge, there is a need for public policies to continue treatment with multiprofessional team until the complete recovery of physical and emotional capacity.